Changes in left atrial structure and function after catheter ablation and electrical cardioversion for atrial fibrillation.
BACKGROUND
The aim of this study was to assess whether the morphological and functional changes of the left atrium (LA) differ after catheter ablation (ABL) from those after electrical cardioversion (ECV) in atrial fibrillation (AF).


RESULTS
AF patients who had maintained sinus rhythm for 3 months after either ECV (n=30) or ABL (n=33) were studied. Both 2-dimensional and Doppler echocardiography were performed at baseline, 1 week, 1 month, and 3 months after these procedures. LA dimensions, mitral inflow velocity, and tissue Doppler imaging of the mitral annulus were examined. LA dimensions decreased in both groups. The mean late mitral annulus velocity increased from 1 week to 3 months in both groups, but the mean late transmitral peak velocity increased only in the ECV group (42.1+/-14.4 cm/s to 56.7+/-14.8 cm/s, p<0.001 vs 38.7+/-12.5 cm/s to 44.8+/-16.7 cm/s, p=NS).


CONCLUSIONS
Reverse morphological remodeling of the LA occurred after successful ABL and ECV for AF. However, because LA function was lower in the ABL group than in the ECV group and did not recover to the baseline levels until 3 months after ABL, a meticulous anticoagulation program should be considered.
Choi
Jong-Il
JI
Division of Cardiology, Department of Internal Medicine, Korea University Hospital, Korea University College of Medicine, Seoul, Republic of Korea.
Park
Seong Mi
SM
Park
Jae Seok
JS
Hong
Soon Jun
SJ
Pak
Hui-Nam
HN
Lim
Do Sun
DS
Kim
Young-Hoon
YH
Shim
Wan Joo
WJ
D000368:Aged; D047228:Angiotensin II Type 1 Receptor Blockers / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D000925:Anticoagulants / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D016279:Atrial Function, Left; D017115:Catheter Ablation; D015150:Echocardiography, Doppler; D004554:Electric Countershock; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000503:physiopathology; D020127:Recovery of Function; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
D047228:Angiotensin II Type 1 Receptor Blockers; D000806:Angiotensin-Converting Enzyme Inhibitors; D000889:Anti-Arrhythmia Agents; D000925:Anticoagulants